VBAC vs. Repeat C-section?

Ugh, here I am up at 2 am having contractions every 10 or 15 minutes or so… Not enough to be meaningful, but enough to keep me awake. These started last night at 3 am, followed by, excuse me if this is TMI, the passing of a bloody mucus plug. I’m 39 weeks pregnant, and I thought, OK, here we go!

But, nay, today, per the OB, my cervix is only 1 cm dilated, and though 70% effaced, wasn’t enough to get excited about. So hubby and I had a nice lunch and went home.

The OB had done an ultrasound, as we’re trying to decide whether or not to have a repeat C section, or go for the VBAC (Vaginal Birth After Cesarean). The ultrasound showed a healthy baby about 6 pounds and change—tiny! I should be able to pull off a VBAC, right?

Now, I was insanely determined to have a vaginal delivery first time around, but my baby ended up stuck face-first, and no one realized, and we got into major trouble.

I labored, like most first-time moms, for a ridiculous extended amount of time (well over 24 hours), without epidural for most of it; then pushed for a few hours… in the end, baby decided what we needed to do. Suddenly, there was a gush of thick meconium with chunks of placenta and his heart rate fell and everyone came running and all hell broke loose and off we rolled to emergency C-section.

Babyboy was fine, but he had been at risk; I lost approximately a liter of blood, and was profoundly weak and exhausted after the whole affair. That was a drama that we really do not want to repeat. According to my OB, there is, statistically speaking, about a 30-40% chance of a repeat of this fiasco, as it’s not clear what caused him to be in such a bad position. It could have been the shape of my pelvis. So I’ve been going back and forth about how to proceed with baby # 2.

Pros for a VBAC: faster recovery time. If these contractions get themselves together into something more closely resembling labor, and we deliver tomorrow, I could be home for Christmas!! AND I could lift Babyboy, who at 18 months, needs to be picked up about fifty times a day. With a C-section, you can’t lift anything over 10 pounds for like, 6 weeks. Right! How is that going to work?

Cons for a VBAC: I am terrified of a laceration… I’ve seen many women with urinary and fecal incontinence issues due to bad tears during L+D, and this is a deep-seated fear of mine. And, of course, there are the risks of a uterine rupture, about 1 in 100 to 1 in 500 (depends what studies you look at). Also, about 20-40 % of women who attempt VBAC end up in repeat C-section anyways for various and sundry reasons, and those women who did a trial of labor have a higher chance of postpartum infection.

Pros for a C-section: No drama! Baby exits safely. And there is a lot to be said for an intact perineum.

Cons for a C-section: Recovery time. as above, I can’t really imagine being in the hospital for 5 days after delivery, at Christmastime to boot, with 6 weeks of no-lifting… This does not seem realistic with a little one already at home. And, one needs to consider all the risks of major abdominal surgery… damage to adjacent organs, infection, etc.

Sigh. So, I’m hoping that baby decides for us, again. Or that something happens to make it all perfectly clear.

Meantime it’s 2:30 am and the cat thinks I am nuts for being awake. These contractions are so annoying. And yet, tomorrow may bring us a Christmas Babygirl!